What is PCNL?
Percutaneous Nephrolithotomy (PCNL) is a minimally invasive “keyhole” surgical procedure used to remove large or complex kidney stones. When stones are too big or hard to pass naturally, or cannot be effectively cleared with non-invasive shockwave therapy, or ureteroscopy, PCNL offers a safe and highly effective solution.
When is it recommended?
Our urology team typically recommends PCNL for:
- Kidney stones larger than 2 centimetres in diameter.
- Complex or branching stones (known as staghorn calculi) that fill multiple parts of the kidney.
- Very hard stones that are resistant to other treatments.
- Stones located in areas of the kidney that are difficult to reach via standard ureteroscopy.
What to expect during the procedure
PCNL is performed under a general anaesthetic, so you will be completely asleep throughout the surgery. The surgeon makes a tiny incision (roughly 1 centimetre wide) in your back or side to create a direct path into the kidney. Using a specialised miniature telescope (a nephroscope) and precision instruments—such as laser or ultrasound energy—the stone is broken into small fragments and gently removed. At the end of the procedure, a temporary drainage tube or internal stent is placed to support healing and ensure normal urine flow.
Watch this video which gives an overview of the procedure.